Survival and Larynx Preservation in Early Glottic Cancer: A Randomized Trial Comparing Laser Surgery and Radiation Therapy

Pihla Pakkanen; Heikki Irjala; Taru Ilmarinen; Elina Halme; Paula Lindholm; Antti Mäkitie; Tuija Wigren; Leena-Maija Aaltonen

doi:10.1016/j.ijrobp.2022.01.010

Survival and Larynx Preservation in Early Glottic Cancer: A Randomized Trial Comparing Laser Surgery and Radiation Therapy

Int J Radiat Oncol Biol Phys. 2022 May 1;113(1):96-100. doi: 10.1016/j.ijrobp.2022.01.010. Epub 2022 Feb 11.

Authors

Pihla Pakkanen¹, Heikki Irjala², Taru Ilmarinen³, Elina Halme⁴, Paula Lindholm⁵, Antti Mäkitie⁶, Tuija Wigren⁷, Leena-Maija Aaltonen³

Affiliations

¹ Department of Otorhinolaryngology - Head and Neck Surgery, University of Helsinki and Helsinki University Hospital, Helsinki, Finland. Electronic address: pihla.pakkanen@helsinki.fi.
² Department of Otorhinolaryngology - Head and Neck Surgery, University of Turku and Turku University Hospital, Turku, Finland.
³ Department of Otorhinolaryngology - Head and Neck Surgery, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
⁴ Department of Otorhinolaryngology - Head and Neck Surgery, University of Tampere and Tampere University Hospital, Tampere, Finland.
⁵ Department of Oncology, University of Turku and Turku University Hospital, Turku, Finland.
⁶ Department of Otorhinolaryngology - Head and Neck Surgery, University of Helsinki and Helsinki University Hospital, Helsinki, Finland; Division of Ear, Nose and Throat Diseases, Department of Clinical Sciences, Intervention and Technology, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden; Research Program in Systems Oncology, Faculty of Medicine, University of Helsinki, Helsinki, Finland.
⁷ Department of Oncology, Tampere University Hospital and University of Tampere, Tampere, Finland.

PMID: 35164976
DOI: 10.1016/j.ijrobp.2022.01.010

Abstract

Purpose: The prognosis of glottic T1a laryngeal squamous cell carcinoma (LSCC) is excellent with both transoral laser surgery (TLS) and radiation therapy (RT). Our aim was to compare TLS and RT treatment results in a randomized study.

Methods and materials: Of 56 male patients with glottic T1a LSCC, 31 were randomized for TLS and 25 for RT. Survival and larynx preservation data were collected from medical records.

Results: Five-year overall survival (OS) was 87%, disease-specific survival (DSS) was 97%, and recurrence-free survival (RFS) was 81% in patients treated with TLS. Five-year OS was 92%, DSS was 100%, and RFS was 88% in patients treated with RT. The primary treatment method was not associated with OS, RFS, or DSS in a log-rank test. The larynx preservation rate was similar in both groups (TLS, 97%; RT, 92%; P = .575).

Conclusions: In a prospective randomized setting oncological outcomes of both treatment modalities (TLS or RT) for T1a LSCC were similar.

Publication types

Randomized Controlled Trial
Research Support, Non-U.S. Gov't

MeSH terms

Female
Glottis / pathology
Glottis / surgery
Head and Neck Neoplasms* / pathology
Humans
Laryngeal Neoplasms* / pathology
Laryngeal Neoplasms* / radiotherapy
Laryngeal Neoplasms* / surgery
Laser Therapy* / methods
Male
Neoplasm Staging
Prospective Studies
Retrospective Studies
Squamous Cell Carcinoma of Head and Neck / pathology
Survival Rate
Tongue Neoplasms* / pathology
Treatment Outcome